Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $486.90 / $4,962.67 / $8,798.12	Facility		$486.90	$4,962.67	$8,798.12
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $200.64 / $243.45 / $486.45	Facility	52	$200.64	$243.45	$486.45
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $80.25 / $97.38 / $194.58	Facility	53	$80.25	$97.38	$194.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.30 / $434.47 / $1,056.31	Professional		$224.30	$434.47	$1,056.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $100.85 / $222.86 / $963.77	Professional	52	$100.85	$222.86	$963.77
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.34 / $88.18 / $215.72	Professional	53	$40.34	$88.18	$215.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,089.75 / $1,089.75 / $2,310.00	Facility		$1,089.75	$1,089.75	$2,310.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.33 / $524.72 / $1,158.50	Professional		$299.33	$524.72	$1,158.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $374.73 / $651.51 / $1,051.30	Professional		$374.73	$651.51	$1,051.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $302.14 / $645.88 / $1,158.55	Facility		$302.14	$645.88	$1,158.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $342.78 / $667.00 / $1,053.29	Professional		$342.78	$667.00	$1,053.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $427.05 / $787.79 / $886.41	Facility		$427.05	$787.79	$886.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $302.14 / $701.55 / $1,299.54	Facility		$302.14	$701.55	$1,299.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $379.72 / $611.24 / $1,133.18	Professional		$379.72	$611.24	$1,133.18
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $2,830.49 / $3,730.83 / $4,636.00	Facility		$2,830.49	$3,730.83	$4,636.00
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $381.32 / $756.53 / $1,184.50	Professional		$381.32	$756.53	$1,184.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,472.00 / $3,700.00 / $5,517.00	Facility		$1,472.00	$3,700.00	$5,517.00
United Facility/Professional Professional Modifier Low / Median / High Price $618.63 / $903.21 / $1,350.95	Professional		$618.63	$903.21	$1,350.95